We’re secretly winning the war on cancer
216 comments
·June 8, 2025leakycap
dumb1224
The common cancer treatment modalities: surgery, radiotherapy, chemotherapy, targeted drugs and their combinations are very effective first line treatments. I agree the statistics are much better.
In the field of cancer research it has been focusing more on drug / treatment resistance, heterogeneous response to the same treatment and development of less invasive methods both in treatment and assessment (imaging and monitoring). We have made huge progress in terms of deeper understanding of cancer biology and human disease mechanism in general.
However we have a very long way to understand when things progress outside of our control how to respond. E.g the key cancer drivers have been identified long ago but how biology and evolution modulate its response to external treatment has so much unknowns. That requires large effort to push the whole foundation of science to elucidate the details of these processes in my opinion.
zevets
I take four pills a day and the primary side effect is weight gain. The earlier 1950s era treatment made me exhausted 24/7. There's a new trial that has a new target, and looks to solve the remaining symptoms of the disease, with effectively no side effects
The big problem is that it's a chronic blood cancer, so the pills have a list price of $180k/yr. Who knows if my insurance will cough up for a second big-money prescription/
blacksmith_tb
My father is 15y out from a trial (at MD Anderson) that put his CLL into remission. You may already know about The Leukemia and Lymphoma Society[1] but they can help with the cost of prescriptions (including negotiating the prices down with the pharmaceutical companies!)
EasyMark
At that cost it's worth looking into moving to a country that actually has reasonable medical costs instead of laws protecting those milking the system. a Plan B?
jplrssn
Some countries with publicly funded healthcare make immigration much more difficult if you have an expensive health condition. This is the case for Canada for example [1].
[1] https://www.canada.ca/en/immigration-refugees-citizenship/se...
zevets
My actual co-pay is $10/mo for the good stuff, plus warfarin (eliquiis/xeralto were too weak for me :/) which is ~$12 for a 90 day supply from the mail order PBM pharmacy. I average about $1500/yr in out-of-pocket medical expenses. My company self insures, and has an extremely generous insurance plan.
Plan B is wait until 2028, when it goes off patent. I think I can keep my job til then. I've learned from the HR folks that they just signed another 3 yr contract with the insurance company, so I'm not forseeing any major changes to coverage. This drug is super pricey, as it was originally targeted towards people with acute cancers, but now the largest market is the chronic disease patients, but they never lowered the price.
I suspect the insurer/PBM are making a small fortune off of my care. They are also being sued by the pharmaceutical industry for using a "co-pay maximizer" which caps (patients) out-of-pocket co-pays, and goes after the pharmaceutical companies' "charities" which help patients purchase their products, which the insurer then takes a cut from.
And the weight gain isn't fluid, it's definitely body fat. I think the weight gain is from the "baseline" treatment being a mutagenic chemotherapy, and the likely fact that my (previously) enlarged spleen was impinging on my stomach limiting my appetite, and the lived fact that it massively slows your metabolism, as I'm always a bit cold.
xandrius
I'm not sure how that would work, do countries accept this kind of behaviour?
It's like you've been paying your (lower) taxes in country X and now come over to enjoy the saner system. I guess you should have chosen your priorities earlier?
Xenoamorphous
Out of curiosity, when some medication causes weight gain, how does it work? Does it increase appetite? Or does it slow metabolic rate?
hansvm
Prednisone is a pretty common drug with weight gain as a side effect, so that might be a good place to look further.
It increases water retention (obviously not permanent or unbounded), increases appetite, and redistributes fat (giving the appearance of weight gain).
kolinko
Usually, aside from water retention, it’s the appetite, I would assume. Lower metabolic rate by itself would lower the appetite because the person would feel less hungry.
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dghughes
Not OP but I'd guess fluid retention.
Loughla
Usually it's just fluid.
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wileydragonfly
I’ve met people that have moved to Houston for cancer treatment there, were given 1-2 years to live, and they’re still here 15-20 years later. It is a really remarkable place.
yellow_lead
MD Anderson is great.
The greater Houston area has too much cancer, in part caused by the many refineries and chemical factories. At least there are good treatment options nearby.
looofooo0
Any statistics on this claim?
apwell23
fr 90% of cancer treatment just slash, burn or poison.
xattt
You mention rapid debulking following an infusion. That must have been a surreal experience. Congratulations!
How does the treatment you received compare to the current standard of care? Would current therapies also result in rapid debulking as well?
leakycap
I remember the little clear IV looked like saline and the nurse said, "Your insurance is getting billed $75,000 for this, so lay back and enjoy" - that was one of many expensive treatments, I was very lucky to have good insurance.
I was told the rapid debulking was because the first infusion I got was a targeted drug that specifically found and destroyed the cancer cells.
The follow up chemo was R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone), and my understanding this regimen is still being used.
Loughla
My dad just went through lymphoma treatment using R-CHOP in 2024. It really is like a miracle. He felt like shit for a day after treatment (actually he felt like shit for one entire day, three days after treatment because he was pumped so full of steroids). Otherwise no real side effects.
gaoshan
>the progress being amazing, and I hope it continues.
and that it does not require being lucky to receive, as you were.
leakycap
All things have to start somewhere. My insurance paid the extreme prices that this rare treatment required at the time, and my treatment meant they had more data (and now a decade of follow up) to verify if the treatment works.
I didn't have a job with insurance because of luck, in fact I was aware enough of medical costs I chose which job I accepted based on the medical benefits.
I was lucky to be alive at a time treatment was available and within reach of a modern working person, not lucky like the Queen's nephew being promoted.
I think saying I was single and working my first job out of college should put it in perspective here. I didn't drive a Cadillac to my chemos. Stuff costs money, especially medical R&D, production, and care delivery.
apwell23
Thing with any cancer treatment is that it works miraculously for someone somewhere and makes it to the news all over.
But it rarely translates to that level of success with masses of cancer patients.
jghn
That is overly reductive. Treatments are measured by metrics such as 5 year survival, 10 year survival, progression-free survival, overall survival, etc. Further, when evaluating a new treatment it will be compared against the current standard of care: does it provide better overall survival? if not, does it at least provide better progression-free survival?
apwell23
right i wasn't talking about incremental improvements, Which there have been many. But there hasn't been a fundamental breakthrough to achieve what gp is describe for 99% of advanced cancers.
> Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone.
melling
Tell us the ugly truth then paint a happy picture.
“for one in six deaths around the world, killing nearly 10 million people a year globally and over 600,000 people a year in the US.”
A lot of reduced deaths come from less smoking and early detection. We will eventually get there but we need a lot more research.
Get a colonoscopy at 45. We are seeing a big increase in younger people.
https://www.cancerresearch.org/blog/colorectal-cancer-awaren...
andreareina
> Get a colonoscopy at 45. We are seeing a big increase in younger people.
N.B. this is not just an increase in detection (as could happen with more/better screening where the true rate isn't changing), but mortality:
> In people under 55, however, death rates have been increasing about 1% per year since the mid-2000s. https://www.cancer.org/cancer/types/colon-rectal-cancer/abou...
margalabargala
It's certainly the case that colorectal cancer is becoming more common, and among younger people. Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.
However, the fact that mortality has been decreasing above the age of frequent screenings, and increasing below that age, tells us that whatever the problem, the symptom (cancer) could be addressed with better screening, leading to earlier detection and treatment.
Mortality is increasing in young people because they don't get screened, so when it does happened no one catches anything until it's too late.
If the age for recommended regular colonoscopies was 40 or 45, we would see the same mortality reduction above that cutoff.
oarfish
> Plenty of possible reasons; diet, plastics, PFAS, all of the above, take your pick.
I think obesity is the main confounder in all such statistics. Thats the thing that has most markedly gone up over the past decades
duffpkg
FOBT which you can do painlessly at home for a few dollars is not meaningfully less preventative than an invasive colonoscopy and carries almost no risk. https://www.nejm.org/doi/full/10.1056/NEJMoa2208375
ljf
Very true, and this is what caught my father's bowel cancer and saved his life.
That said, for someone with increased risk, nothing compares to a colonoscopy - at it does a better job of catching things early, before you start getting blood in your poo.
But if you are at a standard risk, doing a fobt every couple-few years is hugely important. Ask your doctor now!
dillydogg
The superior stool based test would be the FIT-DNA test, which compares favorably to a colonoscopy in sensitivity. These are covered by insurance in the US.
www.nejm.org/doi/full/10.1056/NEJMoa1311194
vharuck
However, if pre-cancerous polyps are found during a colonoscopy, they can be removed right then.
Of course, the best prevention is one that people actually do.
N_Lens
FOBT = Fecal Occult Blood Test (A highly sensitive test for detecting blood in poop even at tiny concentrations).
tjpnz
How effective is it when you get one every year? The idea of a colonoscopy scares the shit out of me (pun not intended).
limaoscarjuliet
I have done mine at 50, you are half asleep, does not hurt, you do not remember anything. Fasting day before is the worst part.
All in all, nothing to worry about, just do it.
jghn
While earlier detection has been beneficial, there's such a thing as too much. Really, there's balance to be struck. For instance the detection procedures themselves (even things like non-invasive imaging) aren't risk free themselves, false positives can set off a chain of events that carry their own harm, and even it's not at all uncommon to develop cancers you "die with" instead of "die from" but once they're detected you have to assume the worst - and treatment itself causes its own form of harm.
greedo
Getting one annually is not recommended for most patients. After my bowel resection, I had annual colonoscopies for five years, then every three years, now every five (the normal recommendation for my age cohort).
Colonoscopies are no big deal from my perspective, but they do have some risk; bowel perforation being the primary one. The prep stuff is the worst aspect for most patients; I used to love lemon lime Gatorade before I used it once as a way of drinking the liquid laxative...
bravesoul2
Thanks for the reminder. My containers to shit in are waiting to be picked up from the doctor's office.
Looks like colonoscopy is better from your link.
hn_throwaway_99
The issue with things like cologuard is they really only detect cancer. Colonoscopies can prevent cancer by having polyps removed before they turn into cancer.
Colonoscopy is a more invasive procedure obviously, but complication rates are very low. It's worth it to find a great gastroenterologist to do the procedure.
bravesoul2
Yeah wish I had grabbed one last time I had an endoscopy.
TechDebtDevin
Prostate cost nothing now in your 30s too
fnordpiglet
I know at least a dozen people in my family and friend network that are alive now after treatment from a cancer that was fatal in most cases 20 years ago. That’s not proof by any measure but I am certainly thankful it’s not 20 years ago.
wat10000
Until things radically change, people are always going to die of something. The more people avoid death from other things, the more people live long enough to die from cancer.
mkfs
[flagged]
fooblaster
My father died last week of cancer. I'm glad for the progress, but winning seems a bit much.
Spooky23
I'm sorry for your loss. I lost my wife to cancer two years ago.
Obviously it didn't work out as we wanted, but she had real hope and prospects. A decade ago, her diagnosis was a guaranteed death sentence. It a nasty business, but at some level, oncology is a field where we stand on the shoulders of those before us. The hope that these tragedies we experience will help future victims brings some comfort personally.
leakycap
I'm very sorry to hear this, and I hope with time you're surrounded by many good memories of better times with your father.
Taylor_OD
I lost one parent to cancer but the other has been cancer free for over ten years now. I'm devastated by the lose of one parent but incredibly grateful for the one who beat their cancer.
Is that winning? I dont know. But the likelihood that my other parent would still be around if they got their same cancer now is already higher than it was when they passed. Nothing can bring my other parent back but we can prevent others from losing their loved ones.
charamis
I'm sad to read this, as my father too is not in the best possible situation currently, cause of cancer. Wish you feel better soon and keep fond memories of him.
phrotoma
Here's to your dad, may he rest easy and be remembered well.
nektro
winning isn't won. i'm sorry for your loss.
devmor
I’m sorry for your loss, stranger.
I lost my father to cancer last year as well - the medical system failed him, his pain treated as exaggerated and his symptoms ignored until it was far too late.
There’s no win for our dads, but I hope the progress prevents future people like them from facing what they did.
dogman123
My dad was diagnosed with multiple myeloma 2 years ago. His bone marrow transplant failed (frequent first line of defense) and he just finished CAR-T therapy a couple months ago. The initial side effects from the treatment were _bad_, but everything is looking good right now. CAR-T is really mindbogglingly insane cyberpunk stuff.
willismichael
I had a close relative diagnosed with multiple myeloma 25+ years ago (I don't remember the exact year) who only lived for a couple more years. It was rough back then. I'm really glad to hear that there is much better treatment these days.
prog_1
not "war on cancer" and not "we" winning. It's pharma finding ways how to profit from rare treatment successes of few rare disease types. Majority, and by majority i mean over 80%, of patients and cancer types are still treated with bogstandard chemo+radio+surgery. Individualized treatment plans using checkpoint inhibitor combinations, biotech therapies, etc are for few select individuals with A LOT of money.
how do i know? i work in precision oncology for a decade plus
leakycap
I think perspective is important here.
I'm alive because pharma developed an expensive drug that, at the time I got it, was only administered to 42 others before me.
I was a single person working my first job out of college with Blue Cross Blue Shield and got the best I think was available.
You might be jaded after working so long in a difficult industry; the medical research/pharma work done matters to the patients who receive it and get another decade+ of good life.
prog_1
im glad for you and every single patient that benefits from something i work on. From the public health angle of most eu countries investment into novel cancer treatments makes a lot less sense that improving prevention.
rlpb
> Individualized treatment plans using checkpoint inhibitor combinations, biotech therapies, etc are for few select individuals with A LOT of money.
This is the first step in the commoditization of any new treatment, no? Initially expensive but that creates competition to bring the price down.
[Maybe not in the US though because the customer cannot select their supplier]
elmolino89
You may check Europe. I can assure you that patients getting PD-1 inhibitors etc. while if I am not mistaken at least in part recruited for clinical trials pay zilch, nada for the drugs there are taking (in Spain).
missedthecue
I don't know... Advancements like Keytruda are huge. And it will be off patent soon. And there are over 1500 active CAR-T clinical trials going on as we speak.
elric
Great that treatment options are improving. But there are still serious bottlenecks in medicine. It seems to be a universal truth that getting a CT/MRI comes with a long wait time. General Practitioners often wait too long to order imaging as a result, and they are often unwilling to even consider cancer in younger people.
We need better (earlier) detection and faster access to it.
oaththrowaway
Just went through the process recently...
Luckily Urgent Care was able to go from ultrasound to CT scan in 1 day. The long wait time has come from the insurance honestly.
Had to go to a different hospital because the original one I went to has to get an approval from United before getting it done (other hospital 2 blocks away doesn't have that same requirement??)
I got referred to a dedicated cancer center and then guess what, I have to call United and ask them to approve it - but I can't get an appointment to do that for 2 weeks.
Ended up doing all the legwork on my own and was able to get a consultation done within a week. Now I'm having to do biopsies, PET scan, ect. Depending on the result I might be able to get it removed next week!
But the pain has become so severe I can't eat, sleep, even lay down without extreme discomfort. I can't imagine waiting around on the insurance to walk me through it.
Funny enough, United sent us a letter in the mail asking if I really wanted to get that original CT scan! Like no, I'd rather not know I have a 7" tumor in my abdomen. Simply a joke of an industry
hcurtiss
I had a knee injury. Called my local orthopedic clinic (seven doctors). The lady who answered the phone told me I’d need to schedule an appointment . . . to schedule the appointment. I was three weeks out from the call at which I would schedule the appointment that would likely be months after that. American medicine is totally broken.
surement
Universal in what country? In the US I've had two MRIs in the last few years for non urgent things and both were scheduled within less than a week.
vel0city
The hold up is usually almost entirely insurance related for most people. People in my family (including myself) have had non-emergency imaging done several times over the past few years. We've had experiences ranging from getting it done same day to taking over a month to get approval and scheduled. This is in DFW, where there's no shortage of MRI machines around.
Meanwhile there are imaging labs that can do walk-ins if you're willing to pay cash and they have the slack in their schedule, usually somewhat cheap compared to what they'll bill insurance (and if you have a HDHP, what you'll pay). They don't want those machines idle, a gap in the schedule is money they aren't making.
jjmarr
I was wondering why Americans purchased MRI gift cards.
ChadNauseam
> It seems to be a universal truth that getting a CT/MRI comes with a long wait time.
I wonder if this is regional. I was able to get an MRI scheduled within a couple weeks when I needed one for my non-urgent condition. This was in Chicago, so maybe we're just blessed with a surplus of MRI machines.
mr_mitm
I was able to get one for my head once on the same day. One of the symptoms must have raised some major red flags, I guess. This was in Heidelberg, they have a huge medschool. For my knees I waited for weeks, if not months, though.
barney54
Just outside Washington, DC my MRIs were scheduled within 4 days.
jghn
> It seems to be a universal truth that getting a CT/MRI comes with a long wait time
It 100% depends on your situation. I've had two clinical MRIs done in my life. One was same day. One was scheduled out a few days.
resource_waste
> getting a CT/MRI comes with a long wait time.
How long? It took me 1 day to get a CT at a clinic and a few hours in the ER.
hansvm
I've seen anything from weeks to months. Weeks when it's the imaging center being booked, months when insurance requires pre-approval or something and times things poorly (hitting the legal deadline but missing the procedure's date for their approval, using the prior approval to deny "getting another" procedure on the date you rescheduled the missed scan, etc).
elric
Two months for me. PET/CT has even longer waiting times here.
fumeux_fume
"Secretly," but perhaps in the sense that most are not exclusive enough to have the coverage, disposable income and proximity to specialists. A close family member of mine was diagnosed with stomach cancer at a very young age. I looked into getting an endoscopy and it took more than a month to see my primary for the referral and about seven months out for the endoscopy. The hospital says there a chance insurance will cover nothing.
bamboozled
The difficulty is that we only care about healthcare for everyone when we're affected, not before. Realistically, every man woman and child in the USA should demand better by organizing massive peaceful protests.
agumonkey
https://archive.is/ibUdx just in case
also, recently ferroptosis made the news as general mechanism to kill metastases https://www.nature.com/articles/s41586-025-08974-4
seems like a new path too, the more the better :)
ps: apparently cancer drug resistance is linked with tumor adaptability which relies on iron and copper, and these researchers leverage this as a weapon against itself, very clever
crubier
Are you french by any chance?
This article made big news in France recently, but I have not heard of it anywhere else. I'm wondering if that thing is really the revolution it's been touted and I just missed the international news talking about it, or if it's just another example of "Look, France is great!" propaganda by french media.
Edit Note: I'm french.
agumonkey
Yeah I'm french and it seems that yeah it was promoted above average, that said, this is the first time I hear about the ferroptosis strategy (and it seems a fine tuned approach) so I guess it's not 100% self-flattering (r. rodriguez didn't seem the narcissistic kind either). And it was old news and I fell for the publicity then I apologize.
duffpkg
CAR-T and closely related immunotherapies are the definitive breakthrough. It will continue to get more and more effective against more and more types of cancers. The research issues surrounding them now are about cost and about how to manage the potentially fatal complications from using it against certain situations, especially developed solid tumors.
Noelia-
I’ve always felt like cancer is one big war, but in reality, it’s more like countless small battles happening all at once. I have a friend who went through this — he had a very rare form of cancer and had to do multiple rounds of chemo, and each round felt like starting over again because what worked once didn’t always work again.
Now, seeing that cancers once thought to be nearly hopeless have five-year survival rates going up, it’s really impressive. I just hope we’ll keep seeing more good news like this in the future.
JohnBooty
it’s more like countless small battles happening all at once
I hope your friend is doing okay.
edm0nd
>World wars, anyway! (May there never be another)
there without a doubt will be another one at some point in time imo
gus_massa
I agree. Relevant PhD Comics: https://phdcomics.com/comics/archive.php?comicid=1162
nektro
if only kamala had won and we didnt just cancel a bunch of research like this
mberning
My brother in law just got diagnosed with Glioblastoma yesterday. He’s only 31. Sadly I don’t think we are winning fast enough for him or people in his situation.
readthenotes1
mcbain
Sadly Richard has now had recurrence. There is still hope for this treatment for others, and it likely extended his life, but it isn't happily ever after this time.
canucker2016
Link to a recurrence article, 2025 March 10: https://www.abc.net.au/news/2025-03-10/richard-scolyer-poor-...
more recent update from 2025 June 11: https://www.dailymail.co.uk/news/article-14800467/Professor-...
I was lucky enough to be seen by MD Anderson doctors for my rare type of cancer. Within hours of the first painless infusion, the large tumors I could feel and see from the outside were completely gone. Hours, truly.
Now, the rest of the chemo wasn't as easy as the first. But the miracles of modern medicine, thanks to dedicated researchers and medical teams, truly blew my mind and that was a decade ago.
I was told I was one of 42 people ever that MD Anderson had seen with this cancer, yet they were able to tailor a treatment. I think Vox is right about the progress being amazing, and I hope it continues.